Sports Medicine

What role do preventative

actions play in enhancing the

wellbeing of the athlete?

Physical preparation

• Preparing the body before competition will improve an athlete’s ability to respond to changing conditions without injury, and enhance their overall performance.

• Pre-screening– Participating in physical activity at any

stage of a person’s life is important for optimal health.

– If an individual has not participated in any physical activity for an extended period, or has a pre-existing medical condition, it is essential they undergo a pre-screening check before they return to physical activity.

– A pre-screening check is usually completed by a GP or a personal trainer prior to physical activity being undertaken.

– It involves a series of questions which give an overview of an individual’s health.

– During exercise, the body changes to adapt to the increase of oxygen and blood flow around the body, and is placed under increased stress.

– These changes have a significant impact on the health of a person with a preexisting health condition, or on a person who has been inactive for some time

• Skill and technique– All sports include activities that carry a risk

of injury.– Incorporating good technique during

training when developing skills will only improve performance and reduce the risk of injury.

– Incorrect technique can lead to an increased risk of both sudden and delayed injuries, and must be corrected immediately.

• Physical fitness– When athletes have a good level of

physical fitness, they are able to cope with the demands of sport more effectively, perform well and minimise their risk of injury.

– As the body gets tired, good skill and correct technique disappear, and poor technique leads to greater injuries.

• Warm up, stretching and cool down– A warm-up allows the body to prepare itself

slowly for an increase in functioning. – It does this by:

• increasing muscle temperature, which allows muscles to contract quicker and with more force

• increasing muscle elasticity, which reduces the risk of sprains and strains

• activating the sweating process so the body can cool efficiently

• increasing the range of motion around a joint.

– A cool-down should last at least 10 minutes using moderate to low activity with the aim to gradually decrease the activity level.

– By gradually slowing down the body, the heart slows down and prevents blood from pooling in the working muscles.

Sports policy and the sports environment

• Sports clubs, schools and government agencies involved in providing physical activity need to provide safe environments in which athletes, coaches, officials and spectators can participate safely.

• Policies should cover the following areas:• maintenance of playing areas and equipment• qualifications of coaches, staff and officials• first aid• duty of care• codes of conduct for players, officials, spectators and parents• risk management procedures in the event of an emergency• injury prevention.

Policies should be written, distributed and continually reviewed.

• Rules of sports and activities– Rules exist to provide structure, competition

and safety in a sport. – The risk of injury increases when rules are

not followed. – Specific rules aim to reduce the likelihood of

an athlete being injured.

• Modified rules for children– Many sports have modified rules to cater for

the different needs of children.– Applying the same rules to children as adults

can increase the risk of injury and overheating, as children’s bodies are still growing and their capacity for thermoregulation is not as well developed.

– Modified rules allow children to still enjoy playing sport, but enable them to develop their skills gradually and improve their fitness.

• Matching of opponents– Because children grow at different rates, it is

important for sports associations to be aware of the different sizes of children who are the same biological age.

– There is a growing number of children who are reaching maturation earlier, or who are bigger in size for their age, and thus are able to generate a greater force when colliding with an opponent.

– Some young players develop exceptional skills beyond their age group.

– While it may be beneficial to move these players into higher grades and age categories, coaches run the risk of injuring the young athlete if the move happens too suddenly

Use of protective equipment• Protective equipment is designed to reduce the risk of

injury to both the athlete and their opponents• Objects within the sporting area that could injure an athlete

may also be fitted with protective equipment

Shin pads

Gloves

Helmet

– Protective equipment should not restrict the athlete or create hazards to opponents.

– It is only effective if it is fitted correctly, appropriate to the sport and comfortable, and does not interfere with participation in the sport.

– Incorrectly fitted equipment can actually cause injury instead of preventing it.

– Any protective equipment should also meet safety standards for the sport in which it is being used.

• Safe grounds, equipment and facilities– Playing areas, equipment and facilities deteriorate over time,

increasing the risk of injury. – Sports organisations, schools and government agencies

need to ensure playing grounds and facilities are well maintained and safe for people to play sport.

– Ideally all playing areas should be level and free from holes, debris and cracks.

– Grass should be cut regularly, and any holes should be filled in.

– Equipment being used during training or competition needs to be well maintained.

– Rain can quickly change the conditions of sport grounds, items of equipment and facilities. It is therefore essential that extra precautions are taken during wet weather to reduce the likelihood of injuries.

– A risk assessment should be conducted on all playing grounds, equipment and facilities before any training or competition takes place.

Environmental considerations

• High or low environmental temperatures can have a significant impact on the body’s physiological structures, as the body tries to adapt and maintain its core body temperature (thermoregulation).

• Temperature regulation– For the body to maintain a constant core

temperature, heat loss must match heat production.

– This process is controlled by the hypothalamus.– When core body temperature (37 degrees

Celsius) falls outside its acceptable range, the hypothalamus initiates a series of physiological actions to try to regain core body temperature.

• Heat loss– The body has five different ways in which to lose heat:

1 Radiation. This is the transfer of heat from one surface to another through space with no physical contact between objects, e.g. radiation produced by the infrared rays of the sun.

2 Convection. This is the transfer of heat through direct contact with air or water (gases) and the body, e.g. skiing at a fast speed as opposed to skiing slowly in the same wind conditions.

3 Conduction. This is the transfer of heat from the body through direct contact to a cooler object, e.g. swimming in a pool on a hot day where the body transfers its heat to the water and warms the water.

4 Evaporation. This occurs when heat from the body in the form of liquid (sweat) is converted to a gas to remove heat from the body, e.g. sweating during a soccer match on a warm day. Heat loss during exercise is usually a result of evaporation.

5 Respiration. This is the transfer of heat through the exhaling of warm air and gases, e.g. an increase in breathing rate when bushwalking.

• Exercising causes the body to produce heat. If this heat is not lost, it will impact on an athlete’s performance.

• The evaporation of sweat is the body’s main source of heat loss when exercising. However, exercising in hot and/or humid environments places stress on the body, making it more difficult for the body to lose heat to maintain its core body temperature.

• Climatic conditions– The climate in which an athlete trains and

competes can affect their physiological functioning and therefore their performance.

– Both hot and cold climates place greater stress on the body, making it more difficult for the body to function effectively.

• Hot and humid conditions– Warm weather is often accompanied by high

humidity, which refers to the amount of moisture in the air—the higher the humidity, the greater the moisture in the air.

– In conditions of lower humidity, evaporation is greater (for example, perspiration evaporates from the skin).

– High humidity, however, results in slower evaporation, therefore athletes find that sweating does not lower the body’s temperature so efficiently.

– When an athlete exercises or competes on a hot, humid day, added pressures are placed on the body to cool its core body temperature.

– When the body overheats, blood vessels undergo vasodilation - they expand to allow heat to be lost more effectively.

– As a result, the body is more susceptible to heat stroke and heat exhaustion, known as hyperthermia.

• Cold conditions– Cold conditions lower the core body temperature and

impact on the physiological functioning of the body. – In order to maintain the body’s core temperature, blood

vessels constrict to reduce the amount of heat lost.– This is known as vasoconstriction. If the body temperature

drops too low, hypothermia can develop.– Athletes can reduce the risk of hypothermia while

exercising in cold conditions by wearing suitable clothing to keep them warm.

– However, in cooler weather it is also important to dress in layers so the body does not overheat—if the body heats up, one layer can be removed at a time, ensuring the body cools gradually rather than suddenly.

• Altitude– When competing in an area that is above sea

level, an athlete will have less oxygen available to their body than they would at sea level.

– The lack of oxygen at high altitudes means the transportation of oxygen is limited, so the body has to produce more red blood cells to cater for the oxygen demands.

– At high altitudes, an athlete’s body may find it difficult to take in and transport the necessary oxygen for optimal performance.

• Air pollution– Air pollution can cause injuries and illnesses to

athletes participating in physical activity. – An increase in air pollution can trigger asthma and

various other respiratory illnesses. – High pollution levels during training or competition,

make it harder for the body to take in oxygen. – A lack of oxygen in working muscles will hinder

overall performance.

• Guidelines for fluid intake– For the body to function effectively, it needs to be

hydrated.– Participating in physical activity causes the body

to lose fluid through sweating, so replacing this fluid loss is vital.

– Replacing fluid during physical activity is important as it allows core body temperature to be maintained, improves concentration and thus improves performance.

– As a general rule, an athlete loses 1 litre of fluid for 1 kilogram of weight they lose while participating in physical activity.

• Acclimatisation– Allowing the body to adapt to environmental conditions

is known as acclimatisation.– It generally takes 7–14 days for adaptations to occur.

During this time, the body’s physiological functioning responds to the environmental climate.

– An athlete who has undertaken acclimatisation training in the heat prior to an event is able to exercise with a lower core temperature and heart rate.

– When an athlete’s body makes these adaptations, it reduces the chance of the body overheating and developing a heat illness, such as heat stroke or hyperthermia.

– Athletes can train in cold conditions to acclimatise their bodies, however adaptation to colder temperatures is assisted by the use of thermal clothing to maintain core body temperature.

Taping and bandaging

• Taping or bandaging of body parts is common in sport.

• There are many reasons why an athlete may choose this method of protection, the most common reasons are for the rehabilitation of an injury or the prevention of an injury.

• Preventive taping– Athletes sometimes want the extra security of

preventing injuries and may use taping or bandaging to give extra support to a body part.

– When preparing an area for taping, the following aspects need to be considered:

• Is there area dry and clean?• Is the area free of hair?• If the athlete is allergic to tape, has underwrap

been applied to the skin?

• There are certain measures that must be considered when starting to tape.– Assess the size of tape that will be used for the area,

and consider how this may restrict movement.– Place the body part being taped in the position it will

need to stay in.– Identify muscles or joints which will be taped, and

allow for contraction and expansion of this area.– Ensure there is overlap of tape.– Roll tape straight onto the area.– Ensure tape is smooth and firm.– Minimise wrinkles in the tape by following the contour

or the body part.

• Once a body part has been taped, it is important to check that:– circulation has not been impeded—the body

part should be normal in colour– normal feeling is present at the body part– the taping restricts movement at the body

part.

1. Positioning - leg straight and foot dorsi flexed

2. Anchors. Apply two anchor stirrups at the base of the calf muscle

3. Stirrups. Start from the medial side of the anchor, coming underneath the heel and anchoring off on the lateral side of the anchor stirrup. Repeat three times. Stirrups should

overlap

4. Figure six. Starting on the medial side, follow the stirrup down and under the heel, bring the tape across thefront of the ankle and attach tothe start of the figure six. Repeat on oppositeside. Complete two figures of six on each side.

Taping an ankle

5 Heel lock. Start onlateral side, come across thefront of the ankle, behind and below the heel,and under the foot. Finish at the starting point.

6 Anchor. Repeat ananchor over the initialanchor to lock all taping off.

• Taping for isolation of injury– When injuries occur, taping is used to

strength and isolate the muscles to prevent the recurrence of injury.

– Ensuring an injured area is supported will give athletes increased confidence to return to play.

– While isolating an injury with tape, it is also important to strengthen the injured site.

– Strengthening and conditioning the injured muscles, tendons and ligaments are important for a full recovery.

• Bandaging for immediate treatment of injury– Using bandages for immediate treatment of

injuries can prevent further damage to the injury sustained.

– For a soft tissue injury, a bandage can compress a suspected sprained ankle to help reduce inflammation.

– Alternatively, bandages can immobilise a fractured leg by tying the legs together, or supporting a dislocated shoulder by giving pain relief and comfort.